Twisted concepts in pain relief

By Judie Brown

No one can deny that the idea of relieving the excruciating pain of a suffering patient is a good idea. But when the culture of death is in charge, the results can be far from good. With greater frequency we find that even the provision of "palliative care" can be fraught with questionable practices.

Regarding the subject of palliative care, the Catholic Church has a common-sense position set forth in the 1980 Vatican document Declaration on Euthanasia http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19800505_euthanasia_en.html where it is stated that, as long as the goal is not to intend the death of the patient, it is permissible to use painkillers. "However, painkillers that cause unconsciousness need special consideration. ... Thus Pius XII warns: 'It is not right to deprive the dying person of consciousness without a serious reason.'"

Expert researcher on this subject, Dr. Elizabeth Wickham of Life Tree, has pointed out, "The low profile wing of the euthanasia movement seeks to blur the line between 1) traditional palliative care in the form of true pain relief, symptom management, etc. and 2) imposed death." If you don't believe such a thing is possible, just consult Life Tree's chronology of the pro-death movement at http://www.lifetree.org/timeline/timelinePrintable.html .

Today the lines are blurring at such a rapid rate that there is open discussion about terminal sedation as merely a type of palliative treatment. Pro-life advocate Ron Panzer, from Hospice Patients Alliance, http://www.hospicepatients.org explains, http://www.lifeissues.net/writers/pan/pan_32intendedkilling.html

The new use of "terminal sedation" intentionally to end lives is the "Third Way" used in many hospices, some hospitals and elsewhere. This misuse of terminal sedation involves the sedating of patients who are not terminally agitated, delusional or psychotic and have no clinical need to be sedated. They are sedated into a coma where they obviously are not conscious enough to safely eat or drink. They are intentionally denied nutrition and liquids orally because to do so would cause aspiration of the materials into the lungs. Since this type of "terminal sedation" keeps the patient comatose permanently, they die of dehydration.

In other words, a patient can be left to die of dehydration with the explanation that these drugs are necessary in order to keep the patient comfortable. Who would know the difference?

Panzer tells us that, in cases like this, "families are coerced into watching their loved one killed, slowly, through medically-induced comas, consequent medically-induced inability to eat or drink, and consequent death through dehydration." This is a frightening scenario for those who have seriously ill loved ones.

So when the New York Times came out with the headline, "Palliative care extends life, study finds," http://www.nytimes.com/2010/08/19/health/19care.html we were not exactly excited about it. Once one reads between the lines, it is quite clear that the intent of the article is to blur the message of the original study published in the New England Journal of Medicine. The actual study states http://www.nejm.org/doi/full/10.1056/NEJMoa1000678 "Early introduction of palliative care also led to less aggressive end-of-life care, including reduced chemotherapy and longer hospice care. Given the trends toward aggressive and costly care near the end of life among patients with cancer, timely introduction of palliative care may serve to mitigate unnecessary and burdensome personal and societal costs."

On the other hand, the Times describes palliative care as merely "pain relief and other measures intended to improve a patient's quality of life." This is obviously quite different from what the New England Journal of Medicine article states.

Why would the Times do this? Is it intent on misleading the public into believing that palliative care is not a course of action that leads to death when in the wrong hands because cost savings are more important than loving and providing comfort to a dying patient?

No sooner had the Times report come out than the Center to Advance Palliative Care http://www.capc.org/ was on the airwaves and internet with its version of talking points designed to advance its cause. The group emphasizes the "improve the patient's quality of life" aspect of care as defined, not by the doctors who did the study, but rather by reporters at the New York Times. Clearly it is believed that the media version of the clinical study will serve well the purposes which CAPC has in mind — namely to maintain momentum in the field of pain relief treatment based on its view that http://www.capc.org/about-capc/faqs "Experience working on or with a palliative care service will not only effectively educate health professionals across the country, but will also contribute to the social and culture-change movement needed to fundamentally improve our health care system."

"Social and culture change" designed to accomplish what? Could it be to advance the "change" embraced by the Obama vision of health care reform?

Each of us may use our interpretive powers to ascertain what these highly subjective words might mean but, for my money, it's all about "relieving" patients of their lives as family and loved ones look on — never suspecting that something else might be going on that could have been avoided.

Now is the time for vigilance. Now is the time for defense of human dignity. And now is the time for advocacy for the proper, ethical and moral use of medications which should be relieving pain — not killing people.

© Judie Brown